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In Japan, children are immunized against pertussis (whooping cough) with an acellular vaccine, which is usually given at two years of age. (The acellular vaccine contains a fraction of the whole pertussis component, which contains antigen and thus stimulates an antibody response.) Although the incidence of pertussis in Japan is low, a number of children younger than two years of age develop the disease each year. This study examined if younger children could be given the vaccine safely and if it would provide adequate protection against pertussis. The Takeda acellular pertussis vaccine was given to infants and children who had no prior history of pertussis vaccination or the disease itself. The children were monitored for any side effects, and the effectiveness of vaccination was evaluated by testing for antibody production. The children were categorized by age: 139 infants aged 3 to 8 months, 60 infants and children aged 9 to 23 months, and 99 children aged 24 to 30 months. A total of four doses were given. Results showed that after the fourth dose, there was a good antibody response toward pertussis toxin (PT) and filamentous hemagglutinin (FHA) in all groups. Initial PT antibody levels were 1.4, 1.1, and 1.1 enzyme-linked immunosorbent assay units per milliliter (EU/mL) for the 3- to 8-month group, the 9- to 23-month group, and the 24- to 30-month group, respectively. After the final dose was given, these levels increased to 67.8, 105.4, and 92.9 EU/mL. Between 28 and 38 percent of the vaccinated infants and children experienced minor side effects such as drowsiness or soreness at the injection site, but no major side effects occurred in response to vaccination. These results indicate that children as young as three months of age can safely be given the Takeda acellular pertussis vaccine and that it elicits an effective antibody response. Several tables describe antibody responses, seroconversion and reactions to vaccination. (Consumer Summary produced by Reliance Medical Information, Inc.)

A systematic trial of the efficacy of the Takeda acellular vaccine for the prevention of whooping-cough (pertussis) in Japanese children is described. This vaccine does not contain intact cells, but does contain cellular fragments which have been found to spur the development of immunity. In 1947 a vaccine containing whole-cells began to be used in Japan, and by the mid 1970s the disease was well under control. Concerns regarding the safety of the vaccine, and a shift of the normal time of administration from three months of age to two years have led to a marked decrease in pertussis vaccines in recent years. Starting in about 1979, epidemics of considerable size marked by severe problems and death occurred. In 1981 a new vaccine, which did not contain whole cells and was combined with vaccine against diphtheria and tetanus, began to be used in Japan. Epidemic pertussis is again under control in Japan; however, children under the usual age of inoculation (two years of age) remain at two- to threefold risk. The occurrence of pertussis was studied among 62 vaccinated children who were exposed at home and 62 unvaccinated children who were similarly exposed. Fifteen percent of inoculated children become ill following exposure, as compared with 76 percent of the children who did not receive immunization. All of the cases of children who had been immunized were mild and were not distinguishable from other upper respiratory tract infections. The study estimates that vaccination is effective in preventing typical pertussis in 98 percent of children, and is 81 percent effective against all pertussis-like symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract. Aberration of IgA-bearing peripheral blood lymphocytes in children with Henoch-Schoenlein purpura has been investigated. Eighteen children with Henoch-Schoenlein purpura demonstrated a marked increase of IgA-bearing lymphocytes in peripheral blood during the acute phase of the disease. The levels of IgA-bearing lymphocytes returned to the normal levels after the acute symptoms of Henoch-Schoenlein purpura had subsided. However, in patients who developed purpura nephritis, the increased levels of IgA-bearing lymphocytes in peripheral blood were retained after the disappearance of purpura, and lasted for more than 12 months. It is concluded that the monitoring of IgA-bearing peripheral blood lymphocytes is useful for the screening of patients with Henoch-Schoenlein purpura and purpura nephritis. Pediatrics 64: 918-922, 1979; Henoch-Schoenlein purpura, purpura nephritis, peripheral blood lymphocytes, immunoglobulin A. [ABSTRACT FROM AUTHOR]